MN 580 MIDTERM EXAM 2025/2026 WITH
ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED ANSWERS
|FREQUENTLY TESTED QUESTIONS AND
SOLUTIONS |ALREADY GRADED
A+|NEWEST|BRAND NEW VERSION
!!!|LATEST UPDATE
A 3 year old whose immunizations are up to date has been exposed to measles because of a
localized outbreak among unvaccinated children. The parent reports that the contact with
infected children occurred within the last 2 days at a birthday party. What is the best course of
action?
A. Administer the MMR vaccine to help prevent disease
B. Give antiviral medications at the first sign of symptoms
C. Give the child a dose of immune globulin to mitigate the response
D. Reassure the parent that most exposed children will not get measles.
A. Administer the MMR vaccine to help prevent disease
A preschool age child is brought to the clinic for evaluation of a rash. The primary care pediatric
NP notes an intense red eruption on the child's cheeks and circumoral pallor. What will the NP
tell the parents about this rash?
A. This rash may be a prodromal sign of rubella or roseola
B. The child will need immunization boosters to prevent serious disease
C. This a benign rash with no known serious complications
D. Expect a lacy, maculopapular rash to develop on the trunk and extremities
D. Expect a lacy, maculopapular rash to develop on the trunk and extremities
An unimmunized school age child whose mother is in her first trimester of pregnancy is
diagnosed with rubella after a local outbreak. What will the primary care pediatric NP
recommend?
A. Assessment of maternal rubella titers
1|Page
,B. Intravenous immunoglobulin for the child
C. MMR vaccine for the mother and child.
D. Possible termination of the pregnancy
A. Assessment of maternal rubella titers
A child is brought to the clinic with a fever, headache, malaise, and a red, annular macule
surrounded by an area of clearing and a larger, erythematous annular ring. The child complains
of itching at the site. What will the primary care pediatric nurse practitioner do to determine
the diagnosis?
a. Ask about recent tick bites
b. Obtain a skin culture
c. Order blood cultures
d. Perform serologic testing
a. Ask about recent tick bites
A child whose family has been camping in a region with endemic Lyme disease suffered several
tick bites. The parents report removing the ticks but are notable to or the length of time the
ticks were attached. The child is asymptomatic. What is the action?
a. Administer a prophylactic single dose of doxycycline.
b. Perform serologic testing for IgG or IgM antibodies.
c. Prescribe amoxicillin three times daily for 14 to 21 days.
d. Teach the parents which signs and symptoms to report.
d. Teach the parents which signs and symptoms to report.
A 10 month old infant has and erythematous, fluctuant, nondraining absess on the right buttock
after 10 days of treatment with amoxicillin for impetigo. What is the next step in managing this
infant's care?
A. Consultation with pediatric infectious disease speacialist
B. Culture of any superficial open surface wounds
C. Empiric treatment with clindamycin
D. Incision and drainage of the abscess with drainage
D. Incision and drainage of the abscess with drainage
A child with a history of a pustular rash at the site of a cat scratch on one arm now has warm,
tender, swollen axillary lymph nodes on the affected side. The primary care pediatric NP notes
2|Page
,induration and erythema of these nodes. What will the NP do?
A. Obtain a CBC and C reactive protein
B. Order IFA for serum antibodies
C. Perform a needle aspiration of the affected lymph nodes
D. Prescribe a 5 day course of azithromycin
B. Order IFA for serum antibodies
A 7 year old child whose immunizations are up to date has a fever, headache, stiff neck, and
photophobia. What course of treatment is indicated?
A. Empiric treatment with oral antibiotics or intramuscular ceftriaxone
B. Hospitalization for diagnosis and treatment with antibiotics
C. Immediate vaccination with meningococcal vaccine
D. Outpatient lab work including CBC, blood and CSF cultures.
B. Hospitalization for diagnosis and treatment with antibiotics
A school age child has a fever of 104 F, sore throat, vomiting, and malaise. The primary care
pediatric NP observes that the tonsils, oropharynx, and palate are erythematous and covered
with exudate, the tongue is coated and red, and there is a red, sand paper like rash on the
child's neck, trunk, and extremities. A rapid strep test is positive. What will the NP do to manage
the child's illness?
A. Administer intramuscular ceftriaxone
B. Hospitalize for further diagnostic tests
C. Prescribe oral amoxicillin
D. Refer to a pediatric infectious disease specialist
C. Prescribe oral amoxicillin
An adolescent has a TB skin test prior to working as a volunteer in a hospital. The adolescent is
healthy and has not traveled to or from a TB endemic area or had close contact with anyone
who has TB. The Mantoux skin test shows 10 mm of induration after 48 hours. What will the
primary care pediatric NP do?
A. Ask the adolescent about exposure to homeless persons
B. Order a chest radiograph to rule out active TB
C. Reassure the adolescent that this is a negative screen
B. Refer the adolescent to an infectious disease specialist
3|Page
, C. Reassure the adolescent that this is a negative screen
The primary care pediatric NP is examining a 2 month old infant with fever and cough. A WBC is
14,000/mm3 and chest radiograph is normal. The infant is nursing well and having normal
stools. What would be an appropriate next step?
A. Admitting the infant to the hospital for LP and IV antibiotics
B. Obtaining blood cultures, ESR, and C reactive protein
C. Performing a catheterized UA to screen for leukocytes and nitrites
D. Prescribing empiric, broad spectrum antibiotics with close follow up
C. Performing a catheterized UA to screen for leukocytes and nitrites
An 18-month-old child with no previous history of otitis media awoke during the night with right
earpain. The primary care pediatric nurse practitioner notes an axillary temperature of 100.5°F
and an erythematous, bulging tympanic membrane. A tympanogram reveals of peak of +150
mm H2O. What is the recommended treatment for this child?
a. Amoxicillin 80 to 90 mg/kg/day in two divided doses
b. An analgesic medication and watchful waiting
c. Ceftriaxone 50 to 75 mg/kg/dose IM given once
d. Ototopical antibiotic drops twice daily for 5 days
b. An analgesic medication and watchful waiting
A child complains of itching in both ears and is having trouble hearing. The primary care
pediatric nurse practitioner notes periauricular edema and marked swelling of the external
auditory canal and elicits severe pain when manipulating the external ear structures. Which is
an appropriate intervention?
a. Obtain a culture of the external auditory canal.
b. Order ototopical antibiotic/corticosteroid drops.
c. Prescribe oral amoxicillinclavulanate.
d. Refer the child to an otolaryngologist.
b. Order ototopical antibiotic/corticosteroid drops.
The mother of a 16yearold male was recently divorced after several years of an abusive
relationship and tells the primary care pediatric nurse practitioner that the adolescent has
begun skipping school and hanging out with friends at the local shopping mall. When she
confronts her child, he responds by saying that he hates her. What will the nurse practitioner
tell this mother?
4|Page
ACTUAL CORRECT QUESTIONS AND
VERIFIED DETAILED ANSWERS
|FREQUENTLY TESTED QUESTIONS AND
SOLUTIONS |ALREADY GRADED
A+|NEWEST|BRAND NEW VERSION
!!!|LATEST UPDATE
A 3 year old whose immunizations are up to date has been exposed to measles because of a
localized outbreak among unvaccinated children. The parent reports that the contact with
infected children occurred within the last 2 days at a birthday party. What is the best course of
action?
A. Administer the MMR vaccine to help prevent disease
B. Give antiviral medications at the first sign of symptoms
C. Give the child a dose of immune globulin to mitigate the response
D. Reassure the parent that most exposed children will not get measles.
A. Administer the MMR vaccine to help prevent disease
A preschool age child is brought to the clinic for evaluation of a rash. The primary care pediatric
NP notes an intense red eruption on the child's cheeks and circumoral pallor. What will the NP
tell the parents about this rash?
A. This rash may be a prodromal sign of rubella or roseola
B. The child will need immunization boosters to prevent serious disease
C. This a benign rash with no known serious complications
D. Expect a lacy, maculopapular rash to develop on the trunk and extremities
D. Expect a lacy, maculopapular rash to develop on the trunk and extremities
An unimmunized school age child whose mother is in her first trimester of pregnancy is
diagnosed with rubella after a local outbreak. What will the primary care pediatric NP
recommend?
A. Assessment of maternal rubella titers
1|Page
,B. Intravenous immunoglobulin for the child
C. MMR vaccine for the mother and child.
D. Possible termination of the pregnancy
A. Assessment of maternal rubella titers
A child is brought to the clinic with a fever, headache, malaise, and a red, annular macule
surrounded by an area of clearing and a larger, erythematous annular ring. The child complains
of itching at the site. What will the primary care pediatric nurse practitioner do to determine
the diagnosis?
a. Ask about recent tick bites
b. Obtain a skin culture
c. Order blood cultures
d. Perform serologic testing
a. Ask about recent tick bites
A child whose family has been camping in a region with endemic Lyme disease suffered several
tick bites. The parents report removing the ticks but are notable to or the length of time the
ticks were attached. The child is asymptomatic. What is the action?
a. Administer a prophylactic single dose of doxycycline.
b. Perform serologic testing for IgG or IgM antibodies.
c. Prescribe amoxicillin three times daily for 14 to 21 days.
d. Teach the parents which signs and symptoms to report.
d. Teach the parents which signs and symptoms to report.
A 10 month old infant has and erythematous, fluctuant, nondraining absess on the right buttock
after 10 days of treatment with amoxicillin for impetigo. What is the next step in managing this
infant's care?
A. Consultation with pediatric infectious disease speacialist
B. Culture of any superficial open surface wounds
C. Empiric treatment with clindamycin
D. Incision and drainage of the abscess with drainage
D. Incision and drainage of the abscess with drainage
A child with a history of a pustular rash at the site of a cat scratch on one arm now has warm,
tender, swollen axillary lymph nodes on the affected side. The primary care pediatric NP notes
2|Page
,induration and erythema of these nodes. What will the NP do?
A. Obtain a CBC and C reactive protein
B. Order IFA for serum antibodies
C. Perform a needle aspiration of the affected lymph nodes
D. Prescribe a 5 day course of azithromycin
B. Order IFA for serum antibodies
A 7 year old child whose immunizations are up to date has a fever, headache, stiff neck, and
photophobia. What course of treatment is indicated?
A. Empiric treatment with oral antibiotics or intramuscular ceftriaxone
B. Hospitalization for diagnosis and treatment with antibiotics
C. Immediate vaccination with meningococcal vaccine
D. Outpatient lab work including CBC, blood and CSF cultures.
B. Hospitalization for diagnosis and treatment with antibiotics
A school age child has a fever of 104 F, sore throat, vomiting, and malaise. The primary care
pediatric NP observes that the tonsils, oropharynx, and palate are erythematous and covered
with exudate, the tongue is coated and red, and there is a red, sand paper like rash on the
child's neck, trunk, and extremities. A rapid strep test is positive. What will the NP do to manage
the child's illness?
A. Administer intramuscular ceftriaxone
B. Hospitalize for further diagnostic tests
C. Prescribe oral amoxicillin
D. Refer to a pediatric infectious disease specialist
C. Prescribe oral amoxicillin
An adolescent has a TB skin test prior to working as a volunteer in a hospital. The adolescent is
healthy and has not traveled to or from a TB endemic area or had close contact with anyone
who has TB. The Mantoux skin test shows 10 mm of induration after 48 hours. What will the
primary care pediatric NP do?
A. Ask the adolescent about exposure to homeless persons
B. Order a chest radiograph to rule out active TB
C. Reassure the adolescent that this is a negative screen
B. Refer the adolescent to an infectious disease specialist
3|Page
, C. Reassure the adolescent that this is a negative screen
The primary care pediatric NP is examining a 2 month old infant with fever and cough. A WBC is
14,000/mm3 and chest radiograph is normal. The infant is nursing well and having normal
stools. What would be an appropriate next step?
A. Admitting the infant to the hospital for LP and IV antibiotics
B. Obtaining blood cultures, ESR, and C reactive protein
C. Performing a catheterized UA to screen for leukocytes and nitrites
D. Prescribing empiric, broad spectrum antibiotics with close follow up
C. Performing a catheterized UA to screen for leukocytes and nitrites
An 18-month-old child with no previous history of otitis media awoke during the night with right
earpain. The primary care pediatric nurse practitioner notes an axillary temperature of 100.5°F
and an erythematous, bulging tympanic membrane. A tympanogram reveals of peak of +150
mm H2O. What is the recommended treatment for this child?
a. Amoxicillin 80 to 90 mg/kg/day in two divided doses
b. An analgesic medication and watchful waiting
c. Ceftriaxone 50 to 75 mg/kg/dose IM given once
d. Ototopical antibiotic drops twice daily for 5 days
b. An analgesic medication and watchful waiting
A child complains of itching in both ears and is having trouble hearing. The primary care
pediatric nurse practitioner notes periauricular edema and marked swelling of the external
auditory canal and elicits severe pain when manipulating the external ear structures. Which is
an appropriate intervention?
a. Obtain a culture of the external auditory canal.
b. Order ototopical antibiotic/corticosteroid drops.
c. Prescribe oral amoxicillinclavulanate.
d. Refer the child to an otolaryngologist.
b. Order ototopical antibiotic/corticosteroid drops.
The mother of a 16yearold male was recently divorced after several years of an abusive
relationship and tells the primary care pediatric nurse practitioner that the adolescent has
begun skipping school and hanging out with friends at the local shopping mall. When she
confronts her child, he responds by saying that he hates her. What will the nurse practitioner
tell this mother?
4|Page
